Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study.
Journal: Journal of global health
Volume: 14
Issue:
Year of Publication:
Affiliated Institutions:
School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China.
School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia.
Department of Social Work, East China University of Science and Technology, Shanghai, China.
School of Nursing, The University of British Columbia, Kelowna, British Columbia, Canada.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia.
Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia.
Department of Internal Medicine, Al-Azhar University, Cairo, Egypt.
Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia.
School of Public Health, JSS Medical College, JSS AHER, Mysuru, India.
Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand.
Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia.
Italian Association against Leukemia, Lymphoma and Myeloma (AIL), Rome, Italy.
Diálogos Guatemala, Guatemala, Guatemala.
School of Nursing, Centro Escolar University, Manila, Philippines.
Nursing Department, Faculty of Health Science, Beirut Arab University, Beirut, Lebanon.
Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.
Department of Psychology, Beirut Arab University, Beirut, Lebanon.
Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azhar University, Cairo, Egypt.
Ergonomics Research Center (ECR), University of Guadalajara, Jalisco, Mexico.
Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain.
Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada.
Faculty of Nursing, Ladoke Akintola University of Technology, Ogbomosho, Nigeria.
Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia.
Department of Optometry, University of Kwazulu-Natal, Durban, South Africa.
Ecove, Ghaziabad, India.
School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia.
Nam Dinh University of Nursing, Nam Dinh, Vietnam.
Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile.
Research Department, National Commission for Medical Arbitration, Mexico, Mexico.
College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Brazil.
Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Benghazi, Libya.
School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda.
Faculty of Medicine, Alzaiem Alazhari University, Khartoum North, Sudan.
Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao.
National Autonomous University of Mexico, Mexico.
Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, Wales, UK.
Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt.
Abstract summary
Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements.We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test.Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05).To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.
Authors & Co-authors:
Li Jiaying J
Fong Daniel Yee Tak DYT
Lok Kris Yuet Wan KYW
Wong Janet Yuen Ha JYH
Man Ho Mandy M
Choi Edmond Pui Hang EPH
Pandian Vinciya V
Davidson Patricia M PM
Duan Wenjie W
Tarrant Marie M
Lee Jung Jae JJ
Lin Chia-Chin CC
Akingbade Oluwadamilare O
Alabdulwahhab Khalid M KM
Ahmad Mohammad Shakil MS
Alboraie Mohamed M
Alzahrani Meshari A MA
Bilimale Anil S AS
Boonpatcharanon Sawitree S
Byiringiro Samuel S
Hasan Muhammad Kamil Che MKC
Schettini Luisa Clausi LC
Corzo Walter W
De Leon Josephine M JM
De Leon Anjanette S AS
Deek Hiba H
Efficace Fabio F
El Nayal Mayssah A MA
El-Raey Fathiya F
Ensaldo-Carrasco Eduardo E
Escotorin Pilar P
Fadodun Oluwadamilola Agnes OA
Fawole Israel Opeyemi IO
Goh Yong-Shian Shawn YS
Irawan Devi D
Khan Naimah Ebrahim NE
Koirala Binu B
Krishna Ashish A
Kwok Cannas C
Le Tung Thanh TT
Leal Daniela Giambruno DG
Lezana-Fernández Miguel Ángel MÁ
Manirambona Emery E
Mantoani Leandro Cruz LC
Meneses-González Fernando F
Mohamed Iman Elmahdi IE
Mukeshimana Madeleine M
Nguyen Chinh Thi Minh CTM
Nguyen Huong Thi Thanh HTT
Nguyen Khanh Thi KT
Nguyen Son Truong ST
Nurumal Mohd Said MS
Nzabonimana Aimable A
Omer Nagla Abdelrahim Mohamed Ahmed NAMA
Ogungbe Oluwabunmi O
Poon Angela Chiu Yin ACY
Reséndiz-Rodriguez Areli A
Puang-Ngern Busayasachee B
Sagun Ceryl G CG
Shaik Riyaz Ahmed RA
Shankar Nikhil Gauri NG
Sommer Kathrin K
Toro Edgardo E
Tran Hanh Thi Hong HTH
Urgel Elvira L EL
Uwiringiyimana Emmanuel E
Vanichbuncha Tita T
Youssef Naglaa N
Study Outcome
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